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Persistent ulcerations in an older woman. 老年妇女持续性溃疡。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-12 DOI: 10.1016/j.adaj.2024.10.012
Hounein Arbaji, Jason Mar, Daria Vasilyeva
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引用次数: 0
Courting water fluoridation 求助于氟化水。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.10.003
J. Tim Wright DDS, MS
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引用次数: 0
Evidence-based approaches and considerations for nonrestorative treatments within modern caries management 现代龋病管理中的非恢复性治疗的循证方法和注意事项:将科学融入实践。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.09.007
Margherita Fontana DDS, PhD, Carlos Gonzalez-Cabezas DDS, MSD, PhD, Livia M.A. Tenuta DDS, MSc, PhD

Background

A high level of scientific evidence supports several nonrestorative strategies for the control of caries, with the goal of reducing progression of mineral loss and arresting existing lesions. The authors provide an overview of evidence for nonrestorative caries control and considerations in the decision making for selecting nonrestorative options.

Types of Studies Reviewed

The authors discuss findings from existing reviews, systematic reviews, and evidence-based guidelines (particularly from the American Dental Association) describing the effectiveness of nonrestorative strategies available in the US market for remineralization and arrest of caries lesions.

Results

Studies support a wide range of products for arresting caries lesions, such as fluorides, sealants, infiltration resins, and chlorhexidine varnish, among others, depending on the tooth surface, primary or permanent dentition, and whether lesions are noncavitated or cavitated. Decisions should be based on appropriate detection, diagnosis, and risk assessment.

Conclusions and Practical Implications

Effective nonrestorative strategies should be used to manage active, noncavitated caries lesions in primary and permanent teeth, and can be considered for managing active cavitated lesions when restorative intervention is not feasible. These lesion-centered interventions should be part of the required overall management of the caries disease process and existing modifiable risk variables at the patient level. They must be monitored over time and reapplied periodically, as needed.
背景:高水平的科学证据支持几种非修复性龋病控制策略,其目标是减少矿物质流失和阻止现有病变的发展。作者概述了非恢复性龋病控制的证据,以及在选择非恢复性方案时的决策考虑因素:作者讨论了现有综述、系统性综述和循证指南(尤其是美国牙科协会)中的研究结果,这些综述、系统性综述和循证指南描述了美国市场上现有的非修复性策略在再矿化和抑制龋损方面的有效性:研究支持多种抑制龋齿病变的产品,如氟化物、封闭剂、渗透树脂和洗必泰清漆等,具体取决于牙齿表面、基牙还是恒牙,以及病变是无龋还是有龋。应根据适当的检测、诊断和风险评估做出决定:应采用有效的非修复策略来治疗原牙和恒牙中活跃的、非龋洞性的龋病病变,当修复干预不可行时,可以考虑采用非修复策略来治疗活跃的龋洞性病变。这些以病变为中心的干预措施应该是对龋病过程和患者现有可改变的风险变量进行必要的整体管理的一部分。必须对其进行长期监测,并根据需要定期重新使用。
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引用次数: 0
Effect of staining solutions on color and translucency stability of resin-composite computer-aided design and computer-aided manufacturing blocks 染色溶液对树脂复合材料计算机辅助设计和计算机辅助制造块体的颜色和半透明稳定性的影响。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.09.003
Luyao Zhang MS, Yang Yu DMD, Sinuo Li MS, Fan Yang MS, Shanshan Liang DDS, PhD, Wenzhong Xing DDS, PhD

Background

The purpose of this study was to investigate the color difference (ΔE00) and translucency changes (ΔTP00) of resin-composite computer-aided design and computer-aided manufacturing blocks after exposure to staining solutions.

Methods

A total of 250 rectangular specimens (1.0-mm thick) were prepared from 4 resin-based composites (Brilliant Crios [Coltène Whaledent], Lava Ultimate [3M], Hyramic [Upcera], and Shofu HC [Shofu]) and a polymer-infiltrated ceramic network material (Vita Enamic [Vita Zahnfabrik]). These specimens were divided into 5 groups and stored in 5 solutions (artificial saliva, cola, black tea, coffee, red wine) at 37 °C for 3, 7, and 14 days to simulate approximately 3, 7, and 14 months, respectively, of clinical staining in the oral environment. Then, toothbrushing was conducted for 4 minutes every 24 hours of immersion to remove extrinsic staining. Measurements of color coordinates were taken at baseline and subsequent testing intervals, and changes in color and translucency were calculated.

Results

The results of the 3-way repeated-measures analysis of variance indicated that material, staining beverages, and time interval and the interactions between these factors collectively affected the alterations in both color and translucency (P < .001). At the 14-day immersion period, the ΔE00 values of all tested materials varied from 0.43 to 2.12 and were clinically acceptable (ΔE00 < 1.8), except for Lava Ultimate and Hyramic in red wine. All materials showed a decrease in translucency, with the ΔTP00 values ranging from −0.23 through −1.34 over 14 days and were clinically acceptable (translucency acceptability threshold < 2.62).

Conclusions

Differences in color and translucency changes were observed between resin-based composites and polymer-infiltrated ceramic network material. All tested materials showed acceptable color and translucency changes when exposed to different staining solutions after the 14-day staining and toothbrushing simulation.

Practical Implications

Discoloration of resin-matrix ceramics due to immersion in solution is related to material type and solutions but is generally acceptable. The dietary habits of the patient should be considered in material selection.
背景:本研究的目的是调查树脂复合材料计算机辅助设计和计算机辅助制造块体暴露于染色溶液后的色差(ΔE00)和半透明度变化(ΔTP00):用 4 种树脂基复合材料(Brilliant Crios [Coltène Whaledent]、Lava Ultimate [3M]、Hyramic [Upcera] 和 Shofu HC [Shofu])和一种聚合物渗透陶瓷网络材料(Vita Enamic [Vita Zahnfabrik])制备了 250 个矩形试样(1.0 毫米厚)。这些试样被分为 5 组,分别在 5 种溶液(人工唾液、可乐、红茶、咖啡、红酒)中于 37 ℃ 下保存 3、7 和 14 天,以模拟口腔环境中约 3、7 和 14 个月的临床染色。然后,每浸泡 24 小时刷牙 4 分钟,以去除外源性染色。在基线和随后的测试间隔测量色坐标,并计算颜色和半透明度的变化:3 向重复测量方差分析结果表明,材料、染色饮料和时间间隔以及这些因素之间的交互作用共同影响了颜色和半透明度的变化(P < .001)。在 14 天的浸泡期,所有测试材料的 ΔE00 值从 0.43 到 2.12 不等,除 Lava Ultimate 和红酒中的 Hyramic 外,其他材料的 ΔE00 值均符合临床要求(ΔE00 < 1.8)。所有材料的半透明度都有所下降,14 天内的ΔTP00 值从-0.23 到-1.34 不等,临床上可以接受(半透明度可接受阈值< 2.62):在树脂基复合材料和聚合物渗透陶瓷网络材料之间观察到了不同的颜色和透光度变化。在经过 14 天的染色和刷牙模拟后,所有测试材料在暴露于不同染色溶液时都显示出可接受的颜色和半透明度变化:浸泡在溶液中的树脂基质陶瓷变色与材料类型和溶液有关,但一般是可以接受的。在选择材料时应考虑患者的饮食习惯。
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引用次数: 0
Ethical concerns with intoxicated adult and pediatric oral health care 醉酒成人和儿童口腔保健的伦理问题。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.10.002
Karen Diane Foster DDS, Debra Peters DDS
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引用次数: 0
Motivational interviewing at home 家庭激励访谈:一项旨在提高智利弱势家庭口腔健康知识水平和降低发病率的社区试验。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.09.012
Ricardo Cartes-Velásquez DDS, MD, PsyD, MPH, MSc, MPhil, PhD, Luis Luengo-Machuca MSc

Background

Limited evidence exists regarding the effects of home-based interventions on oral health outcomes in preschool-aged children or caregivers despite the success of such interventions in other child and pregnancy health outcomes. The aim of this community trial was to assess the impact after 12 months of a home-delivered motivational interviewing (MI) intervention on oral health outcomes in disadvantaged Chilean families.

Methods

This trial was conducted with a community single-blinded design, including preschoolers (aged 2-4 years) and their caregivers from 2 disadvantaged communities who received either the MI intervention or standard oral health interventions at kindergartens. The MI intervention comprised from 4 through 6 tailored home visits by MI-trained dental hygienists. Data on socioeconomic-demographic factors, caries (International Caries Detection and Assessment System [ICDAS]), oral hygiene, and caregivers’ oral health literacy (OHL) (assessed with Oral Health Literacy Instrument and Rapid Estimate of Adult Literacy in Dentistry, 30 items) were collected at baseline and 12-month follow-up.

Results

Two hundred fifty-two dyads completed baseline measurements, and 212 completed the follow-up (control, n = 104; intervention, n = 108). Weak associations were found between clinical-sociodemographic factors and OHL at baseline (correlations, < 0.3) and follow-up. Analysis of covariance revealed a reduction in caries incidence for lesions with ICDAS scores above 0 (P = .03) but not for ICDAS scores above 2 (P = .47). No reduction in oral hygiene was observed (P = .74). Oral Health Literacy Instrument scores showed no improvement (P = .10), and Rapid Estimate of Adult Literacy in Dentistry, 30 items scores showed a marginal increase (P = .03).

Conclusions

Home-delivered MI intervention had a marginal impact on preschoolers’ caries incidence and caregivers’ OHL but no effect on preschoolers’ oral hygiene, with the primary impact observed at the level of caries ICDAS scores above 0.

Practical Implications

Home-delivered MI interventions by dental hygienists marginally reduce caries incidence in preschoolers from disadvantaged populations. This trial was registered at the Australian and New Zealand Clinical Trials Registry. The registration number is ACTRN12615000450516.
背景:尽管以家庭为基础的干预措施在其他儿童和妊娠健康结果方面取得了成功,但有关这些干预措施对学龄前儿童或照顾者口腔健康结果的影响的证据却很有限。这项社区试验的目的是评估 12 个月后在智利贫困家庭中开展的家庭激励访谈(MI)干预对口腔健康结果的影响:该试验采用社区单盲设计,包括来自 2 个贫困社区的学龄前儿童(2-4 岁)及其照顾者,他们在幼儿园接受了激励式访谈干预或标准口腔健康干预。口腔健康管理干预包括由受过口腔健康管理培训的牙科卫生学家进行的 4 到 6 次有针对性的家访。在基线和 12 个月的随访中收集了有关社会经济-人口因素、龋病(国际龋病检测和评估系统 [ICDAS])、口腔卫生和护理人员口腔健康素养(OHL)(通过口腔健康素养工具和成人牙科素养快速评估,共 30 个项目)的数据:结果:252 个二人组完成了基线测量,212 个二人组完成了随访(对照组,104 人;干预组,108 人)。在基线(相关性小于 0.3)和随访中发现,临床社会人口学因素与 OHL 之间的相关性较弱。协方差分析表明,ICDAS评分超过0分的病灶龋齿发病率有所降低(P = .03),但ICDAS评分超过2分的病灶龋齿发病率没有降低(P = .47)。没有观察到口腔卫生方面的下降(P = .74)。口腔健康素养工具得分没有提高(P = .10),而成人牙科素养快速评估 30 项得分略有提高(P = .03):家庭传递式多元智能干预对学龄前儿童的龋齿发生率和看护者的口腔健康素养有微弱影响,但对学龄前儿童的口腔卫生没有影响,主要影响体现在龋齿 ICDAS 得分超过 0.00 分:实际意义:由牙科保健员进行的家庭传递式口腔卫生干预可略微降低弱势群体学龄前儿童的龋齿发病率。该试验已在澳大利亚和新西兰临床试验注册中心注册。注册号为 ACTRN12615000450516。
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引用次数: 0
Good choices for healthy teeth 这是健康牙齿的好选择。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.10.008
Anita M. Mark
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引用次数: 0
Deepfakes in health care 医疗保健中的深度伪造:解密数字欺骗。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.04.006
Shankargouda Patil BDS, MDS, PhD, Frank W. Licari MBA, MPH, DDS
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引用次数: 0
Emergency department use for nontraumatic dental conditions for children with special health care needs enrolled in Oregon Medicaid 俄勒冈州医疗补助计划(Medicaid)中有特殊健康护理需求的儿童因非外伤性牙科疾病使用急诊室的情况。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.09.009
Kimia Imani MS, Courtney M. Hill MS, Donald L. Chi DDS, PhD

Background

This cross-sectional study evaluated whether children with special health care needs (CSHCN) were more likely to use the emergency department (ED) for nontraumatic dental conditions (NTDCs) than children without special health care needs (SHCN). The study also examined whether the likelihood of receiving an opioid prescription after an NTDC-ED visit differed between children with and without SHCN.

Methods

This analysis was based on 2017 Oregon Medicaid enrollment, claims, and pharmacy data (N = 225,614 children aged 3-17 years). To assess associations between SHCN, NTDC-ED use, and receipt of opioid prescriptions, confounding variable–adjusted odds ratios and 95% CIs were generated from logistic regression models.

Results

Approximately 14% (n = 31,867) of children had an SHCN. The prevalence of NTDC-ED use was 0.36% (n = 807) for all children. In the confounding variable–adjusted model, the odds of NTDC-ED use were 1.6 times greater for CSHCN than children without SHCN (95% CI, 1.3 to 1.9; P < .001). Among children with an NTDC-ED visit, 8.3% received an opioid prescription. In the confounding variable–adjusted model, CSHCN were at lower odds of receiving an opioid prescription after an NTDC-ED visit than children without SHCN, but this difference was not statistically significant (odds ratio, 0.84; 95% CI, 0.4 to 1.6; P = .57).

Conclusions

CSHCN enrolled in Medicaid had significantly higher odds of having NTDC-ED visits than children without SHCN, but there was no significant difference between the 2 groups in the odds of receiving an opioid prescription after an NTDC-ED visit.

Practical Implications

All children, especially those with SHCN, should have adequate access to office-based oral health care through a dental home to reduce use of the ED for NTDC.
背景:这项横断面研究评估了有特殊健康护理需求(CSHCN)的儿童是否比无特殊健康护理需求(SHCN)的儿童更有可能因非创伤性牙科疾病(NTDC)而使用急诊科(ED)。该研究还考察了有特殊健康护理需求和无特殊健康护理需求的儿童在NTDC-ED就诊后获得阿片类处方的可能性是否存在差异:本分析基于 2017 年俄勒冈州医疗补助计划的注册、理赔和药房数据(N = 225,614 名 3-17 岁儿童)。为了评估 SHCN、NTDC-ED 使用和阿片类药物处方接收之间的关联,从逻辑回归模型中生成了混杂变量调整后的几率比和 95% CI:结果:约 14% 的儿童(n = 31,867 人)患有 SHCN。所有儿童使用 NTDC-ED 的比例为 0.36%(n = 807)。在混杂变量调整模型中,CSHCN 儿童使用 NTDC-ED 的几率是无 SHCN 儿童的 1.6 倍(95% CI,1.3 至 1.9;P < .001)。在接受过 NTDC-ED 就诊的儿童中,8.3% 接受过阿片类药物处方。在混杂变量调整模型中,CSHCN 在 NTDC-ED 就诊后接受阿片类药物处方的几率低于未接受 SHCN 就诊的儿童,但这一差异无统计学意义(几率比 0.84;95% CI,0.4 至 1.6;P = .57):结论:加入医疗补助计划的 CSHCN 接受 NTDC-ED 就诊的几率明显高于未加入 SHCN 的儿童,但在接受 NTDC-ED 就诊后获得阿片类药物处方的几率方面,两组之间没有明显差异:实际意义:所有儿童,尤其是患有 SHCN 的儿童,都应通过牙科之家获得足够的诊室口腔保健服务,以减少因 NTDC 而使用急诊室。
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引用次数: 0
Holistic care for patients with cancer 为癌症患者提供整体护理:在癌症中心整合口腔医学和口腔肿瘤学服务的新模式。
IF 3.1 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-12-01 DOI: 10.1016/j.adaj.2024.09.014
Alessandro Villa DDS, PhD, MPH, Maggy Pons CPA, MBA, Mark Davis MD
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引用次数: 0
期刊
Journal of the American Dental Association
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